Combined use of strictly anaerobic MBBR and aerobic MBR for municipal wastewater treatment and removal of pharmaceuticals

An integrated lab-scale wastewater treatment system consisting of an anaerobic Moving Bed Biofilm Reactor (AnMBBR) and an aerobic Membrane Bioreactor (AeMBR) in series was used to study the removal and fate of pharmaceuticals during wastewater treatment. Continuous-flow experiments were conducted applying different temperatures to the AnMBBR (Phase A: 35 °C; Phase B: 20 °C), while batch experiments were performed for calculating sorption and biotransformation kinetics. The total removal of major pollutants and target pharmaceuticals was not affected by the temperature of the AnMBBR. In Phase A, the average removal of dissolved chemical oxygen demand (COD), biological oxygen demand (BOD), and ammonium nitrogen (NH₄-N) was 86%, 91% and 96% while in Phase B, 91%, 96% and 96%, respectively. Removal efficiencies ranging between 65% and 100% were observed for metronidazole (MTZ), trimethoprim (TMP), sulfamethoxazole (SMX), and valsartan (VAL), while slight (<30%) or no removal was observed for carbamazepine (CBZ) and diclofenac (DCF), respectively. Application of a mass balance model showed that the predominant mechanism for the removal of pharmaceuticals was biotransformation, while the role of sorption was of minor importance. The AeMBR was critical for VAL, SMX and TMP biodegradation; the elimination of MTZ was strongly enhanced by the AnMBBR. In both bioreactors, Bacteroidetes was the dominant phylum in both bioreactors over time. In the AnMBBR, Cloacibacterium and Bacteroides had a higher abundance in the biocarriers compared to the suspended biomass.

Comparing the use of a two-stage MBBR system with a methanogenic MBBR coupled with a microalgae reactor for medium-strength dairy wastewater treatment

Two systems were compared for medium-strength dairy wastewater treatment. The first comprised a methanogenic Moving Bed Biofilm Reactor (AnMBBR) and an aerobic MBBR (AeMBBR), while the second an AnMBBR and a sequencing batch reactor (SBR) with Chlorella sorokiniana. The AnMBBR, under ambient conditions, achieves biogas production sufficient enough to attain energy autonomy. The produced energy was 0.538 kWh m^-3, whereas the energy consumption 0.025 kWh m^-3. Its coupling with the AeMBBR removed COD, NH₄-N TKN, and PO₄-P by 93 ± 4%, 97 ± 3%, 99 ± 1% and 49 ± 15%, respectively, while the use of the SBR as a second step eliminated totally COD but partially the other pollutants. The higher nitrogen removal in the first system was due to nitrification occurring in the AeMBBR. The acclimatization of microalgae to dairy wastewater enhanced their growth. Their protein content was 54.56%, while starch and lipids were 3.39% and 23.1%, respectively.

Detection of profilin in SPT extracts that are supposed to contain it

INTRODUCTION AND OBJECTIVES

Profilin is a panallergen contained in pollen, plant foods and latex. Although cross-reactivity is expected while performing skin prick tests (SPT) with allergens that contain profilin, this is not always noticed. The purpose of this study was to detect if profilin is contained in the commercial SPT extracts of pollen and plant foods which, in their fresh form, contain determined epitopes of profilin.

MATERIAL AND METHODS

Commercial SPT extracts of different pharmaceuticals were analyzed using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). The study included purified palm date profilin, peach (whole, pulp and peel extracts), hazelnut, Olea europea, Parietaria judaica and Phleum pratense.

RESULTS

Profilin was detected in all, but peach extracts; it was neither contained in the whole peach extract nor in the ones of peel or pulp.

CONCLUSION

The only accurate way to detect sensitization to profilin, while performing SPT, is the use of purified profilin extract. Even if a plant food or pollen contain an identified molecule of profilin, the relevant SPT commercial extract may not.

Expression of adhesion molecules during normal pregnancy

We review the available information regarding the role of adhesive molecules as potential participants in the complex events of fertilization, embryogenesis, implantation and placentation. Studies that specifically relate to the expression and modulation of adhesive molecules in fertilization, embryogenesis, and implantation have been identified in the literature and by Medline searches. Cell-cell and cell-extracellular matrix interactions play a critical role in various developmental processes and in the cascade of events that lead to implantation and to the normal development of the fetus during pregnancy. Adhesion molecules influence, directly or indirectly, numerous aspects of cell behaviour, cell migration, cell growth, cell survival, cell proliferation, angiogenesis, invasion and metastasis.

Leukocytoclastic vasculitis: is propranolol implicated?

Drugs frequently cause cutaneous adverse reactions. The suspected agent is sometimes difficult to identify, especially in patients receiving multidrug treatment and with underlying illnesses that may contribute to the clinical picture. In our patient, propranolol-induced leukocytoclastic vasculitis was diagnosed by exclusion.

Proarrhythmic effects of reactive hypoglycemia

A patient with refractory atrioventricular nodal reentry tachycardia is reported in whom it was possible to document that reactive hypoglycemia was the trigger for aggravation of arrhythmia. Over a period of 6 years, a series of electrophysiological studies revealed that, when the patient was in a hypoglycemic state, initiation of tachycardia was easy and most importantly that tachycardla termination by extra-stimulus pacing always failed. Furthermore, atrial fibrillation was inducible or spontaneously occurred only when the blood glucose level was reduced by IV insulin administration.

Electrophysiologic studies of the heart in patients with rheumatoid arthritis

We investigated the electrophysiological properties of the heart in patients with definite or classical rheumatoid arthritis using programmed electrical stimulation techniques. Twelve patients with rheumatoid arthritis and without evidence of organic heart disease or arrhythmia detectable with serial electrocardiograms and 24-hour ambulatory electrocardiographic monitoring were compared with 12 control subjects. Stimulation was performed from the high right atrium and right ventricular apex at a drive cycle length of 600 msec and the recording sites included high right atrium, atrioventricular junction and distal coronary sinus. There was no statistically significant difference in the corrected sinus node recovery time between the study and control group of patients. Similarly, no differences from normal were found in the AH and HV intervals or in the atrial and ventricular refractoriness, whereas the atrioventricular nodal effective refractory period was higher in patients with rheumatoid arthritis, compared with the control group (338 +/- 38 vs 286 +/- 29, P less than 0.02). The atrial conduction time during basic cycle length had a tendency to increase from high right atrium to atrioventricular junction in the study group and reached statistical significance from high right atrium to coronary sinus (92 +/- 15 vs 74 +/- 14, P less than 0.05). Electrophysiologic differences between the study and control patients also included a greater increase in maximal intraatrial (40 +/- 13 vs 27 +/- 16, P less than 0.05) and interatrial conduction delay (54 +/- 16 vs 31 +/- 12, P less than 0.01) of early premature stimuli in patients with rheumatoid arthritis.(ABSTRACT TRUNCATED AT 250 WORDS)

A clinical pharmacological comparison of diclofensine (Ro 8-4650) with nomifensine and amitriptyline in normal human volunteers

1 Ten healthy male volunteers participated in a double-blind placebo-controlled crossover comparison of the pharmacodynamic profiles of single oral doses of diclofensine 25 mg and 50 mg, nomifensine 75 mg and amitriptyline 50 mg. 2 Diclofensine did not influence salivary flow or consistently affect pupil diameter and had no significant effect on subjective measurements of sedation and mood. It had no effect on reaction time, or on critical flicker frequency. 3 By contrast, amitriptyline significantly reduced salivary flow, produced significant sedation and impairment of mood, prolonged reaction time, and appeared to decrease (but not significantly) critical flicker frequency. 4 Nomifensine significantly reduced (i.e. improved) reaction time, and inhibited salivary flow. 5 Diclofensine did not significantly influence heart rate, blood pressure, systolic time intervals or high speed electrocardiogram. 6 No significant treatment-related differences were observed in serum prolactin, cortisol or growth hormone levels.

Acute haemodynamic effects of a new calcium antagonist, nicardipine, in man. A comparison with nifedipine

1 The acute cardiovascular response to nicardipine was investigated using non invasive techniques in normal subjects. 2 In six subjects, i.v. nicardipine in an increasing dose (0.5-20 mg) was compared with saline, under double-blind conditions. A dose related increase in heart rate and fall in blood pressure were found. Pre-ejection period (PEP) and PEP/left ventricular ejection time (LVET) ratio of the systolic time intervals were shortened in a clearly dose related manner. Total electromechanical systole index (QS2 I) was decreased and LVET index prolonged. 3 In four subjects increasing oral doses (10-40 mg) of nicardipine, administered in a randomized double-blind placebo control design, demonstrated the same pattern, marked changes being found with the 40 mg dose. 4 Comparison with nifedipine in a double-blind-placebo controlled balanced trial in six subjects confirmed that 40 mg nicardipine and 20 mg nifedipine exhibited similar effects. Maximum response was reached between 0.5 and 1.5 h, and changes in some cardiovascular variables were still evident at 3 h.

Pharmacokinetic interaction between theophylline and erythromycin

1 The pharmacokinetics of a single intravenous dose of theophylline alone and during the fifth day of treatment with 500 mg erythromycin every 8 h was studied in six healthy subjects. 2 At the same time the pharmacokinetics of erythromycin at steady-state on the fourth day of the treatment (alone) and the fifth day (during the theophylline co-administration) were also studied. 3 Mean +/- s.d. theophylline clearance was decreased from 62 +/- 15.4 to 53 +/- 10.3 ml min-1 (P less than 0.05) and elimination half-life rose from 7.1 +/- 1.9 to 7.7 +/- 2 h (P less than 0.05) when erythromycin was co-administered. 4 Mean +/- s.d. erythromycin area under the curves (0-8 h) and (0-oc) were reduced from 6.09 +/- 3.2 to 3.8 +/- 2.5 micrograms ml-1 h and 7.2 +/- 3.6 to 5.0 +/- 2.9 micrograms ml-1 h (P less than 0.05) in the presence of theophylline. Mean steady state and maximum steady state concentrations were also reduced from 0.75 +/- 0.4 to 0.47 +/- 0.3 microgram ml-1 (P less than 0.05) and 1.45 +/- 0.87 to 0.85 +/- 0.51 microgram ml-1 (P less than 0.05) respectively. 5 The potential clinical implications of this indication should be considered.

Should erythromycin dose be altered in haemodialysis patients?

Erythromycin kinetics were studied in 17 patients with end stage renal failure treated with maintenance haemodialysis and 9 normal volunteers to discover if dialysis patients needed a modified dose. The elimination half life in dialysis patients (on dialysis days) was similar to that reported in normal subjects. Only small amounts of drug appeared in the dialysate, no patient loosing more than 9 mg in one dialysis. Both patients and volunteers had similar plasma concentrations 8 h after the end of a 5-day course. Protein-binding did not change significantly during dialysis and was similar to that reported in normal subjects. We conclude that dialysis patients requiring 1.5 g of erythromycin stearate daily or less can be given normal doses.

Fluorimetric and microbiological assays of erythromycin concentrations in plasma and vaginal washings

Using a microbiological and a fluorimetric assay to determine penetration of erythromycin into vaginal fluids, concentrations were measured in plasma from nine men one hour after a single oral dose of erythromycin stearate 2 g and in vaginal washings and plasma samples taken simultaneously from 11 women two hours after the last dose of a 10-day course of erythromycin stearate (250 mg four times daily). Both assay methods gave accurate and reproducible results in plasma but only the fluorimetric method was capable of measuring concentrations of erythromycin in vaginal washings. The latter method had many advantages in estimating drug concentrations in body fluids such as vaginal washings and the results from it may provide an index of tissue penetration and of patient compliance in adhering to drug regimens.